ch 20: drugs for neurologic disorders: parkinson's and alzheimer's disease

Question 1

what type of disease is parkinson’s?

Answer 1

neurodegenerative disease

Question 2

what is the mechanism of action of parkinson’s?

Answer 2

• imbalance of DA (decrease) and ACh (increase)

- degeneration of neurons

Question 3

what are s&s of parkinson’s?

Answer 3

• tremors
• shuffling walk
• rigidity
• postural changes
• drooling

Question 4

what drugs are used for parkinson’s?

Answer 4

• anticholingerics
• dopaminergics
• dopamine agonists
• COMT inhibitors
• MAO-B inhibitors

Question 5

what do anti-cholinergics do for parkinson’s? examples of drugs?

Answer 5

• inhibits release of acheylcholine
• benztropine and trihexyphenidyl HCl
• reduces rigidity and tremors

Question 6

what do dopaminergics do for parkinson’s? examples of drugs? drug-drug interactions?

Answer 6

• carbiopa-levodopa
• converted to dopamine
• increased mobility
• increased hypertensiveness with MAOI due to increased DA leading to increased BP

Question 7

what do dopamine agonists do for parkinson’s? examples of drugs?

Answer 7

• amantadine
• stimulates dopamine receptors
• early treatment for parkinson’s

Question 8

what do COMT inhibitors do for parkinson’s? examples of drugs? what do these drugs end in?

Answer 8

• increases availablility of lecodopa in the brain
• entacapone and tolcapone: prolongs half life of levodopa
• given with levodopa-carbidopa
• (-capone)

Question 9

what are the two categories of dopamine agonists?

Answer 9

• ergot: bromocriptine

- non ergot: ropinorole and pramipexole

Question 10

what do MAO-B inhibitors do for parkinson’s? examples of drugs?

Answer 10

• works with levodopa
• selegiline and rasagiline
• inhibits breakdown of dopamine for the brain to use

Question 11

what are some important interventions for antiparkinson’s disease drugs?

Answer 11

• monitor for orthostatic hypotension
• give with low-protein drugs
• avoid depressants

Question 12

what enzymes do you need to look for with antiparkinson’s drugs?

Answer 12

AST
ALT
ALP

Question 13

what is Alzheimer’s? what age does it typically happen at? what neurotransmitter is at a loss? what are the characteristics?

Answer 13

• incurable dementia illness
• chronic, progressive neurogenerative disease
• marked by cognitive dysfunction
• between ages of 45-65
• decrease in ACh
• memory loss, confusion, inability to communicate

Question 14

what are the drug classes used for Alzheimer’s?

Answer 14

• ACh inhibitors

- NMDA receptor antagonists

Question 15

what is the example of ACh inhibitors? what are side effects? what is a major thing you need to watch for when on this? what type of Alzheimer’s is this used for?

Answer 15

• rivastigmine
• SLUDGE and bradycardia
• watch for falls due to orthostatic hypotension
• mild to moderate Alzheimer’s

Question 16

explain the NMDA receptor antagonist?

Answer 16

• magnesium usually blocks the receptor until more calcium is need in the neuron
• it usually unblocks the receptor and causes a binding in glutamate, which causes calcium to go into the neuron until it has enough then the magnesium will block off the receptor again
• when magnesium cannot do its job anymore, memantine will take over and replace it